Mrs Georgia Russell, APRN is a medicare enrolled "Nurse Practitioner - Family" in Moab, Utah. Her current practice location is
450 Williams Way, Moab, Utah. You can reach out to her office (for appointments etc.) via phone at
(435) 719-3510.
Mrs Georgia Russell is licensed to practice in Utah (license number 209410-4405) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1073785408.
Provider's Profile
| Full Name | Mrs Georgia Russell |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 450 Williams Way, Moab, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1073785408
- Provider Enumeration Date: 03/26/2008
- Last Update Date: 08/16/2018
Medicare PECOS Information:
- PECOS PAC ID: 4880754266
- Enrollment ID: I20081114000283
Medical Identifiers
Medical identifiers for Mrs Georgia Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1073785408 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | 209410-4405 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Georgia Russell allows following entities to bill medicare on her behalf.
| Entity Name | Moab Valley Healthcare, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770513236 PECOS PAC ID: 2466361720 Enrollment ID: O20040114000346 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Georgia Russell is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mrs Georgia Russell, APRN 450 Williams Way, Moab, UT 84532-2185 Ph: (435) 719-3510 | Mrs Georgia Russell, APRN 450 Williams Way, Moab, UT 84532 Ph: (435) 719-3510 |
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